4
By choosing Scripps Health as your provider group for your Southern California Select plan, you’ll have access to hundreds of providers at dozens of locations throughout San Diego County. And as a Cigna customer, you’ll also enjoy 24/7/365 customer support, as well as programs and resources to help you stay well. Experience the Scripps difference With a commitment to medical and service excellence, Scripps Health is constantly evolving to better meet your needs, reduce costs and improve your overall care experience. The providers and staff members will work closely with you to help you take control of your health and live your healthiest life. In 2018, for the second year in a row, the combined programs of Scripps Green Hospital and Scripps Memorial Hospital La Jolla were ranked #1 in the San Diego region for seven specialties. 1 Truven Health Analytics named Scripps Memorial Hospital one of 100 Top U.S. Hospitals in the nation. 2 Scripps Memorial Hospital La Jolla, Scripps Green Hospital and Scripps Memorial Hospital Encinitas were recognized as Top Performers on Key Quality Measures® by the Joint Commission. 3 U.S. News & World Report named Scripps Hospitals the “Best Hospitals in San Diego, California.” 4 Scripps Health in San Diego County You have options With your Southern California Select plan, each member of your family has the option to select one of the four provider groups in the Southern California Select Network, 5 including: HealthCare Partners 6 (Los Angeles County) St. Joseph Hoag Health (Orange County) Scripps Health (San Diego County) PrimeCare (Riverside and San Bernardino counties) COMING TOGETHER TO OFFER YOU MORE The Cigna Southern California Select plan and Scripps Health HealthCare Partners St. Joseph Hoag Health Scripps Health PrimeCare 927657 03/19 Offered by: Cigna HealthCare of California, Inc.

COMING TOGETHER TO OFFER YOU MORE - Cigna · Escondido Carmel Valley Santee La Mesa Eastlake Rancho Bernardo Vista Oceanside Carlsbad ... you have an emergency, dial 911 or go to

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Page 1: COMING TOGETHER TO OFFER YOU MORE - Cigna · Escondido Carmel Valley Santee La Mesa Eastlake Rancho Bernardo Vista Oceanside Carlsbad ... you have an emergency, dial 911 or go to

By choosing Scripps Health as your provider group for your Southern California Select plan, you’ll have access to hundreds of providers at dozens of locations throughout San Diego County. And as a Cigna customer, you’ll also enjoy 24/7/365 customer support, as well as programs and resources to help you stay well.

Experience the Scripps difference

With a commitment to medical and service excellence, Scripps Health is constantly evolving to better meet your needs, reduce costs and improve your overall care experience. The providers and staff members will work closely with you to help you take control of your health and live your healthiest life.

› In 2018, for the second year in a row, the combined programs of Scripps Green Hospital and Scripps Memorial Hospital La Jolla were ranked #1 in the San Diego region for seven specialties.1

› Truven Health Analytics named Scripps Memorial Hospital one of 100 Top U.S. Hospitals in the nation.2

› Scripps Memorial Hospital La Jolla, Scripps Green Hospital and Scripps Memorial Hospital Encinitas were recognized as Top Performers on Key Quality Measures® by the Joint Commission.3

› U.S. News & World Report named Scripps Hospitals the “Best Hospitals in San Diego, California.”4

Scripps Health in San Diego County

You have options

With your Southern California Select plan, each member of your family has the option to select one of the four provider groups in the Southern California Select Network,5 including:

› HealthCare Partners6 (Los Angeles County)

› St. Joseph Hoag Health (Orange County)

› Scripps Health (San Diego County)

› PrimeCare (Riverside and San Bernardino counties)

COMING TOGETHER TO OFFER YOU MOREThe Cigna Southern California Select plan and Scripps Health

HealthCare PartnersSt. Joseph Hoag HealthScripps HealthPrimeCare

927657 03/19 Offered by: Cigna HealthCare of California, Inc.

C44390
Text Box
Expansion of the Southern California Select Network to include PrimeCare providers in the Inland Empire is subject to regulatory approval. Access to the PrimeCare providers is anticipated to be available as of July 2019.
Page 2: COMING TOGETHER TO OFFER YOU MORE - Cigna · Escondido Carmel Valley Santee La Mesa Eastlake Rancho Bernardo Vista Oceanside Carlsbad ... you have an emergency, dial 911 or go to

2

12 Scripps HealthExpress Clinics

6 Hospitals8400+ Primary Care Physicians

1,800+ Specialists

MEXICO

A

BC

D

E

78

56

67

805

5

5

8

15

125

125

163

52

54

94 94

805 163

8

El Camino Real

76

78

La Jolla

San Diego

Chula Vista

Coronado

Escondido

Carmel Valley

Santee

La Mesa

Eastlake

RanchoBernardo

VistaOceanside

Carlsbad

Poway

Murrieta(64 miles from San Diego)

Encinitas

F

2

Southern California Select Network

Locations

■A Scripps Memorial Hospital Encinitas

■B Scripps Green Hospital

■C Scripps Memorial Hospital La Jolla

• Prebys Cardiovascular Institute

■D Scripps Mercy Hospital, San Diego

■E Scripps Mercy Hospital, Chula Vista

■F Rady Children’s Hospital

● Scripps Cardiovascular and Thoracic Surgery

Group (3 locations)

● Scripps Clinic (16 locations)

● Scripps Coastal Medical Center (12 locations)

● Imaging Centers (8 locations)

▲ Radiation Centers (8 locations)

▲ Scripps Whittier Diabetes Institute

(2 locations)

▲ Breast Care Centers (3 locations)

Participating Medical Groups

• Scripps Clinic

• Scripps Coastal Medical Center

• Scripps Physicians Medical Group

• Mercy Physicians Medical Group, Inc.

Scripps HealthExpress Walk-in Clinics

• Carlsbad

• Carmel Valley

• Carmel Valley (Pediatrics)

• Cedar

• Eastlake

• Encinitas

• Hillcrest

• Mission Valley

• Oceanside

• Rancho Bernardo

• Rancho Bernardo (Pediatrics)

• Rancho San Diego

• Solana Beach

• Torrey Pines

Enjoy convenient access to:5,7

To find in-network providers, use the provider directory on Cigna.com, or myCigna.com after your plan effective date. You can also call 800.244.6224 for assistance.

Southern California Select Network in San Diego County

Page 3: COMING TOGETHER TO OFFER YOU MORE - Cigna · Escondido Carmel Valley Santee La Mesa Eastlake Rancho Bernardo Vista Oceanside Carlsbad ... you have an emergency, dial 911 or go to

The Southern California Select plan offers service, support and savings designed to do one thing – help you and your family live your healthiest lives.

3

› 24/7/365 customer service with Spanish-speaking representatives and translation services in over 200 languages.

› 24/7/365 Health Information Line provides access to a clinician for support with things like choosing care, reviewing home treatment and finding the nearest convenience care clinics or urgent care centers.

› myCigna.com and the myCigna® App, offers 24/7/365 access to a variety of tools, programs and resources designed to make it easy for you to manage your plan, your costs and your health.

› Cigna Telehealth Connection lets you talk with a U.S.-based, board-certified provider via phone or video chat, whenever and wherever you need one – for the same out-of-pocket costs as a PCP visit.9

› Cigna Healthy Pregnancies, Healthy Babies® Program offers personalized telephone support from dedicated nurses, as well as online educational materials for everything from infertility and planning through post-delivery.

› Chronic condition management for conditions such as asthma, lower back pain, depression, coronary artery disease and more. A Cigna health coach will work one-on-one with you to create a plan to maintain your health and manage your condition based on your personal goals.

› Lifestyle management programs with access to coaches, who can help you reach your health goals - from losing weight to quitting tobacco to reducing your stress levels.

› Cigna Healthy Rewards® program offers discounts on programs and services that help you live and stay well, such as weight management and nutrition, vision and hearing care, alternative medicine, healthy lifestyle products and more.10

› The Cigna Behavioral Health Network (or Employee Assistance Program Network, if offered by your employer) lets you access behavioral health care and support – from mental health to substance abuse treatment – with no referral required.

› Scripps HealthExpress provides convenient access to 12 walk-in centers treating minor illnesses and injuries (for ages five and older). Call ahead (858.554.7439) to speak with a triage nurse or go to Scripps.org/NowOpen to hold your place in line. Scripps HealthExpress clinics currently have two designated pediatric locations – Rancho Bernardo and Carmel Valley.

› MyScripps is an online portal providing convenient access to most lab tests and medical records. It also allows the ability for online scheduling at Scripps Clinic and Scripps Coastal Medical Center.

› Prebys Cardiovascular Institute is one of the premier destinations for heart care on the West Coast. It’s where some of the nation’s leading cardiologists and cardiovascular surgeons perform the most advanced procedures, and it is available in-network. This includes the region’s first Women’s Heart Center dedicated to treating women with heart disease, staffed by women cardiologists. Scripps cardiology and heart surgery is ranked 23rd in the nation by U.S. News & World Report (2018–2019).11

FREQUENTLY ASKED QUESTIONS

What if I move outside of the network service area? Eligibility for the Southern California Select plan is based on zip code, and you must live or work in Orange, San Diego, Los Angeles, San Bernardino or Riverside counties. If you move outside of the service area, your employer can provide information about your plan options.

What if a dependent moves out of the area? Dependents living outside the service area may be eligible for “guesting” if they are away from the local area for at least 60 days, but not longer than two years. Call Cigna at 800.244.6224 to learn more.

Do I have to use in-network providers and facilities? If you receive care outside the network, it is considered out-of-network and would not be covered by your plan, except for emergency or urgent care.12

For more information, call 800.244.6224 anytime or visit Cigna.com before enrollment. If your plan has already started, you can visit myCigna.com or use the myCigna App.

Page 4: COMING TOGETHER TO OFFER YOU MORE - Cigna · Escondido Carmel Valley Santee La Mesa Eastlake Rancho Bernardo Vista Oceanside Carlsbad ... you have an emergency, dial 911 or go to

Can I change my PCP? You may change your PCP after your plan effective date on myCigna.com, through the myCigna App or by calling Cigna customer service. The change will be effective on the first day of the following month.

What if I’m receiving care from a doctor outside of the network for an ongoing condition? If you meet the requirements and your provider agrees to Cigna’s terms and conditions, you may temporarily receive in-network level benefits for your treatment. Call Cigna customer service for help with a Transition of Care (TOC) or Continuity of Care (COC) request form.

How do I fill my prescriptions? You can fill your prescriptions through Cigna Home Delivery PharmacySM or at any retail pharmacy that is in your plan’s network. For more information, log in to myCigna.com or call Cigna customer service.

How do I know if my prescription is on Cigna’s approved drug list? Cigna customer service can help at 800.244.6224. They may also be able to help you find a less expensive drug alternative or you can use the pricing tool on myCigna.com.

What if my medication needs a prior authorization? Call Cigna customer service at 800.244.6224.

FREQUENTLY ASKED QUESTIONS (Continued)

What if I need to see a specialist? Your primary care physician (PCP) can provide a referral to an in-network specialist or facility if needed or when required by your plan.13

What happens in the case of an emergency? Emergency care is covered at the in-network level. If you have an emergency, dial 911 or go to the nearest emergency facility.12

How do I know if a provider is in-network? Search Find a Doctor, Dentist or Facility at Cigna.com (before your plan starts) or on myCigna.com (after your plan starts) to find in-network providers.

What if I need to see a behavioral health professional? Call Cigna customer service or go to Cigna.com (before your plan starts) or myCigna.com (after your plan starts) to locate an in-network behavioral health professional.

Do all of my family members need to choose the same provider group? Each member of your family has the option to select a PCP at any one of the four provider groups in the Southern California Select Network. Each member will receive care from providers and facilities within the group selected to be considered in-network, except in the case of emergency or urgent care.12

1. 2018-2019 Best Regional Hospitals “Best Hospitals in San Diego, Calif.” U.S. News & World Report. https://health.usnews.com/best-hospitals/area/san-diego-ca. 2. “Truven Health Analytics, IBM Watson Health, Announces 100 Top Hospitals Award Winners.” https://truvenhealth.com/media-room/press-releases/detail/prid/205/Truven-Health-

Analytics-IBM-Watson-Health-Announces-100-Top-Hospitals-Award-Winners. Web, March 6, 2017. 3. “Scripps Health Earns National Quality Honors from Joint Commission.” https://www.scripps.org/news_items/5530-scripps-health-earns-national-quality-honors-from-joint-commission.

Media, November 16, 2015. March 3, 2017. 4. 2018-2019 Best Regional Hospitals’ “Best Hospitals in San Diego, Calif.” U.S. News & World Report. https://health.usnews.com/best-hospitals/area/san-diego-ca 5. Plans may be limited geographically. Providers are located throughout the majority of the counties. 6. Not all HealthCare Partners providers may be in the Southern California Select Network. Includes PCPs, specialists and Allied practitioners. 7. Data as of January 2019 analyzing “unique” provider IDs, subject to change. Access the provider directory on Cigna.com to see what providers are accepting new patients. 8. Includes Rady Children’s Hospital - San Diego. 9. Telehealth services are provided by independent companies/entities and not by Cigna. Providers are solely responsible for any treatment provided. Not all providers have video chat

capabilities and video chat is not available in all areas. Telehealth services are separate from your health plan’s provider network. A PCP referral is not required.10. Healthy Rewards is a discount program. Some Healthy Rewards programs are not available in all states and programs may be discontinued at any time. Healthy Rewards is separate from your

medical benefits. If your Cigna plan includes coverage for any of these services, this program is in addition to, not instead of, your plan benefits. A discount program is NOT insurance, and the customer must pay the entire discounted charge.

11. “Best Hospitals for Cardiology & Heart Surgery.” U.S. News & World Report. https://health.usnews.com/best-hospitals/rankings/cardiology-and-heart-surgery12. Coverage is paid at the in-network benefit level as defined by the plan documents.13. Specific providers like OB/GYN can be seen without a referral. See your plan documents for details or call 800.244.6224.The providers and facilities that participate in the Cigna network are independent practitioners solely responsible for the treatment provided to their patients. They are not agents of Cigna.Exclusions and limitations: All health plans and health insurance policies have exclusions and limitations. Copay, coinsurance and deductible requirements may apply. This brochure outlines the highlights of your plan. For a complete list of both covered and not-covered services, including benefits which may be required by your state, see your plan documents. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Cigna Behavioral Health, Inc., Tel-Drug, Inc., Tel-Drug of Pennsylvania, LLC, and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of California, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, LLC. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only.927657 03/19 As to Cigna content/properties, ©2019 Cigna. Some content provided under license.